Primary invasive signet-ring cell melanoma
Primary invasive signet-ring cell melanoma
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DOI：
10.1111/j.1600-0560.1999.tb01802.x
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发表时间：
1999-11-01
影响因子：
1.7
通讯作者：
Gschnait, F
中科院分区：
文献类型：
--
作者：
Breier, F;Feldmann, R;Gschnait, F
恶性黑色素瘤的组织病理学变异包括常见型（黄斑恶性、浅表性扩散黑色素瘤、结节性黑色素瘤、肢端黄斑性黑色素瘤）、梭形细胞、结缔组织增生、球囊细胞、多形性（纤维组织细胞）、黏液样、小细胞黑色素瘤和恶性蓝痣。最近，印戒细胞黑色素瘤作为一种额外的细胞学变异被引入。我们描述了一个72岁的病人原发性印戒细胞黑色素瘤的皮肤位于上臂。组织病理学检查显示黑色素细胞瘤从表皮延伸到深网状真皮。许多多形性肿瘤细胞在其周围显示大的细胞内空泡和卵圆形至纺锤形核。同时观察到有丝分裂象和多核黑素细胞。部分印戒细胞呈现胞质周期性酸-希夫（PAS）阳性。免疫组化显示肿瘤细胞S-100、HMB-45蛋白和vimentin阳性反应，证实肿瘤细胞向黑素细胞分化。肿瘤细胞角蛋白、上皮膜抗原、癌胚抗原均阴性。印戒细胞黑色素瘤浸润至Clark IV级，肿瘤厚度为2.2 mm。印戒细胞黑色素瘤是一种罕见的黑色素瘤。它的识别对于区分其他印戒细胞肿瘤具有重要意义。
The histopathological variants of malignant melanoma include the common type (lentigo maligna, superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma), spindle cell, desmoplastic, balloon cell, pleomorphic (fibrohistiocytic), myxoid, small cell melanoma and malignant blue nevus. Recently, signet-ring cell melanoma was introduced as an additional cytologic variant. We describe a 72-year-old patient with a primary signet-ring cell melanoma of the skin located on the upper arm. Histopathologic examination disclosed a melanocytic tumor extending from the epidermis to the deep reticular dermis. Numerous pleomorphic tumor cells showed large, intracellular vacuoles and oval to spindle-shaped nuclei at their periphery. Mitotic figures and multinucleated melanocytes were also observed. Some of the signet-ring cells exhibited cytoplasmatic periodic acid-Schiff (PAS)-positivity. Immunohistochemistry showed positive reaction of the tumor cells for S-100, HMB-45 protein and vimentin, confirming their melanocytic differentiation. Tumor cells were negative for cytokeratins, epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA). The signet-ring cell melanoma disclosed an invasion to Clark Level IV and tumor thickness of 2.2 mm. Signet-ring cell melanoma is a rare morphologic variant of melanoma. Its recognition is important for differentiation from other tumors featuring signet ring cells.